Marios Potamitis, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

2195 Station Village Way
Apartment #1406
San Diego, CA 92108-6514

Phone

(760) 908-8094

NPI assigned

Feb 10, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1679931299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 STATION VILLAGE WAY",
            "address_2": "APARTMENT #1406",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 STATION VILLAGE WAY",
            "address_2": "APARTMENT #1406",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921086514",
            "telephone_number": "760-908-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTAMITIS",
        "first_name": "MARIOS",
        "credential": "IDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-10",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Thomas Postlethwaite Jr., IDC
• Sophia Postlewait, PTA
• Eric Lee Poston, IDC
• Tyler Poston, RAC
• Rachel M Postovoit, LCSW, LISW, M.S.
• Anthony Potente, DDS
• Potentia Family Therapy, Inc.
• Bruce Michael Potenza, MD
• Danielle Ann Poth
• Lauren Potocic

• Independent Duty Corpsman in San Diego, CA
• Providers in San Diego, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.